Easy Application Date: Loan Agent you spoke to:: PreQualification   Equity   Debt Consolidation   Refinance Amount Requested:   Purpose: Name:   DOB:   S.S Number: Co-Applicant:   DOB:   S.S Number: Address: City:    State:   Zip: Year Purchased:    Amount Paid:    Current Value: 1st Mortgage Holder:    Balance:    Payment: Percentage Rate of Loan: %    15 YR.     20 YR.    30 YR/ARM OR FIXED 2nd Mortgage Holder:    Balance:    Payment: Percentage Rate of Loan: %    15 YR.     20 YR.    30 YR/ARM OR FIXED Prepayment Pentaly on 1st or 2 nd    YES   NO Expiration:  Amount: Employer:   Years:   Annual Salary: Employer:   Years:   Annual Salary: Home Phone:    Business Phone: How would you rate your credit?    Fair    Good   Excellent Have you ever filed Bankruptcy?    YES      Yar Discharged Have you missed or been over 30 days late in the past year on your mortgage?   YES    NO Have you been over 30 days late on any other debts?    YES     NO What is you combined credit card debt? $ What is your combined monthly paymenty? $ Do you have an auto loan? YES    NO    Balance: $  Montly Payment: $ Do you have any other loans? YES    NO    Balance: $   Payment: $ Do you own any other property? YES    NO   Balance: $   Payments: $ If Yes, How much equity do you have? $ May we run a credit check? YES   NO How did you hear about us?: Email: Comments:

6658 Thornton Avenue Newark, CA 94560 E-Mail info@rainbowfunding.com

1-800-782-LOAN Phone: (510) 791-7923 Fax: (510) 791-5414